| Upper GI endoscopy (EGD), diagnostic (43235) |
$1,048.80 |
$1,311 |
1.0× |
| Upper GI endoscopy (EGD) with biopsy (43239) |
$1,088.80 |
$1,361 |
1.1× |
| Diagnostic colonoscopy (45378) |
$1,567.60 |
$1,959.50 |
1.5× |
| Colonoscopy with biopsy (45380) |
$1,134.40 |
$1,418 |
0.8× |
| Colonoscopy with lesion removal (45385) |
$1,814.40 |
$2,268 |
1.3× |
| CT head/brain without contrast (70450) |
$1,240 |
$1,550 |
10.4× |
| MRI brain without contrast (70551) |
$2,073.60 |
$2,592 |
7.6× |
| MRI brain with contrast (70552) |
$2,732.80 |
$3,416 |
6.9× |
| MRI brain without and with contrast (70553) |
$3,368 |
$4,210 |
8.5× |
| X-ray lower spine, 4+ views (72110) |
$668 |
$835 |
5.6× |
| MRI lumbar spine without contrast (72148) |
$2,360 |
$2,950 |
8.7× |
| CT pelvis with contrast (72193) |
$2,121.60 |
$2,652 |
10.6× |
| MRI lower-extremity joint without contrast (73721) |
$2,228 |
$2,785 |
8.2× |
| CT abdomen and pelvis with contrast (74177) |
$3,360 |
$4,200 |
8.5× |
| Ultrasound, abdomen complete (76700) |
$715.20 |
$894 |
6.0× |
| Ultrasound, pregnant uterus (≥14 weeks) (76805) |
$788 |
$985 |
6.6× |
| Ultrasound, transvaginal (76830) |
$547.20 |
$684 |
4.6× |
| Mammography, one breast (diagnostic) (77065) |
$380.80 |
$476 |
4.4× |
| Mammography, both breasts (diagnostic) (77066) |
$405.60 |
$507 |
3.7× |
| Mammography, screening (bilateral) (77067) |
$601.60 |
$752 |
6.6× |
| Basic metabolic panel (80048) |
$72 |
$90 |
8.5× |
| Comprehensive metabolic panel (80053) |
$91.20 |
$114 |
8.6× |
| Lipid panel (80061) |
$106.40 |
$133 |
7.9× |
| Renal function panel (80069) |
$84.80 |
$106 |
9.8× |
| Hepatic function panel (80076) |
$78.40 |
$98 |
9.6× |
| Urinalysis, non-automated, with microscopy (81000) |
$44.80 |
$56 |
11.1× |
| Urinalysis, non-automated, without microscopy (81002) |
$30.40 |
$38 |
8.7× |
| PSA, total (84153) |
$119.20 |
$149 |
6.5× |
| Thyroid stimulating hormone (TSH) (84443) |
$136 |
$170 |
8.1× |
| CBC with automated differential (85025) |
$86.40 |
$108 |
11.1× |
| CBC, automated (85027) |
$56 |
$70 |
8.7× |
| Prothrombin time (PT) (85610) |
$44.80 |
$56 |
10.4× |
| Partial thromboplastin time (PTT) (85730) |
$64.80 |
$81 |
10.8× |
| Physical therapy, therapeutic exercise (per 15 min) (97110) |
$103.20 |
$129 |
3.6× |
| Office visit, new patient (low complexity, ~30 min) (99203) |
$245.60 |
$307 |
1.6× |
| Office visit, new patient (moderate complexity, ~45 min) (99204) |
$306.40 |
$383 |
2.0× |
| Office visit, new patient (high complexity, ~60 min) (99205) |
$392 |
$490 |
2.6× |
| Office consultation (low complexity, ~30 min) (99243) |
$212.80 |
$266 |
1.4× |